RESUMEN

Rural and remote communities of Western Canada have struggled to recruit and retain nursing professionals since the turn of the twentieth century. Existing literature has identified the unique challenges of rural nursing due to the shifting context of rural and remote nursing practice. The objective of this narrative review is to explore the history of rural and remote nursing to better understand the contextual influences shaping rural nursing shortages in Western Canada. This narrative review compared 27 sources of scholarly and historical evidence on the nature of rural nursing practices and recruitment and retention methods following the First World War until 2023. The findings suggest that the complex nature of rural nursing practice is a consistent challenge that has intersected with the long-standing power inequities that are inherent in rural marginalization, political influences, the nursing profession, social structures, and organizational design, to perpetuate rural nursing shortages throughout the past century. Integration and collaboration are needed to reduce systemic marginalization and develop effective and sustainable solutions to reduce nursing shortages in rural and remote areas of Western Canada.

RESUMEN

AIM: Many forms of critical theory shape nursing research. One approach that is gaining popularity is Carspecken's critical ethnography. This methodology was designed to help researchers understand power relations by merging a critical stance with a complex and dynamic qualitative strategy of inquiry. Despite the appeal of this approach, we argue Carspecken does not adequately address how researchers can minimise researcher biases and dominance when studying power relations. The purpose of this article is to critique Carspecken's implementation of critical theory from the standpoint of lack of attention to bias and reinforcement of oppression. DISCUSSION: The authors explain how greater attention to reflexivity, relationality and reciprocity could reduce opportunities for researcher bias and the potential for oppressive structures and dominant power relations to be reinforced. IMPLICATIONS FOR RESEARCH: Researchers can better address bias and reinforcement of power relations through reflexivity. Bias can be reduced by making explicit values that may privilege particular decisions and observations throughout the research process. Researchers can also reduce bias via relationality or giving participants equal power in decision making and taking action towards social justice. When researchers engage in reciprocity they encourage participants to contribute to all stages of the research process and therein equalise power relations.

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RESUMEN

Over the past several decades, nurses have been increasingly theorizing about the relationships between culture, health, and nursing practice. This culture theorizing has changed over time and has recently been subject to much critical examination. The purpose of this paper is to identify the challenges impeding nurses' ability to build theory about the relationships between culture and health. Through a historical overview, I argue that continued support for the essentialist view of culture can maintain a limited view of complex race relations. I also argue that attempts to apply culture theory, without knowledge of important historical, political, and economic factors, has often resulted in oversimplified versions of what was originally intended. Furthermore, I argue that individual-level interventions alone will be insufficient to address health inequities related to culture. Despite new critical conceptualizations of culture and the uptake of cultural safety, nursing scholars must better address the broader organizational, population, and political interventions needed to address inequities in health. I conclude with suggestions for how nurses might proceed with culture theorizing given these challenges.

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